Ethical dilemmas in achieving universal access to new essential medicines

28th April 2014. 
H Horgezeil, University of Groningen and former Director of Essential Medicines, WHO, Geneva.

The seminar will take place in the College lecture theatre at 9.00 pm. The poster can be downloaded here. About one-third of the world’s population has no regular access to basic essential medicines. But a much larger proportion has no access to new essential medicines, such as second-line anti-retroviral medicines, products against multi-drug resistant tuberculosis, and anti-cancer medicines. There are hardly any childrens’ fixed-dose combinations for the treatment of AIDS, and there are no heat-stable insulin or oxytocin formulations for rural areas without refrigerators. For several infectious diseases, such as leishmaniasis and African sleeping sickness, no safe and effective treatments exist at all. These problems are not limited to low- and middle-income countries: in the western world there are insufficient financial incentives to develop new antibiotics. There are many ethical dilemmas facing health policy makers, health workers, scientists, pharmaceutical companies and others working towards universal access to new essential medicines. Should research priorities be based on free market principles? Should poor patients contribute to the costs of research and development of the life-saving medicines they need? What is the first responsibility of a medical doctor: the individual patient asking for advice, or society as a whole? Do human rights represent universal values, or are they just a Western philosophy? Although clear answers are not always possible, a description of the facts and factors underlying these important questions may help to structure the discussion and facilitate the development of practical responses.

Hans V. Hogerzeil, MD, PhD, DSc, FRCP Edin is Professor of Global Health and the Right to Health at the University of Groningen (Netherlands). He was a mission doctor in India and Ghana. In 1985 he joined the essential medicines programme of the World Health Organization (WHO). Since then he has advised the governments of over forty low- and middle-income countries, including S-Africa, India and China, on the development of their national medicines policies and programmes. From 2004 to 2011 he was Director for Essential Medicines, being responsible for all WHO's global policies, nomenclature and standards on medicines, the WHO/UN prequalification programme, and all technical support to Member States. From 2001 to 2011 he was the Chair of the Interagency Pharmaceutical Coordination Group of all major UN agencies, the Global Fund, the World Bank and UNITAID. Since 2011 he is Chairman of the Board of the Access to Medicine Foundation, which every two years assesses the policies and practices of the 20 largest pharmaceutical companies in relation to access to essential medicines in low- and middle-income countries. Prof Hogerzeil (1951) is the editor of several WHO books and wrote over 80 scientific papers on essential medicines policies. His recent interests include universal access to essential medicines as part of the fulfillment of the right to health, and essential medicines for reproductive health and for non-communicable diseases. In 1998 he received a honorary doctorate of the Robert Gordon University, Aberdeen (Scotland)


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